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Immunogenic lipid markers of atherosclerosis in type 2 diabetic patients on program haemodialysis

T V Archakova1, L V Nedosugova1, N A Nikitina2

  • 1I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Healht of Russia, Moscow, Russia.

Terapevticheskii Arkhiv
|February 1, 2019
PubMed

Insights

Patients with chronic kidney disease (CKD) and type 2 diabetes on hemodialysis show increased desialylated apolipoprotein-B-100 and immune complexes, accelerating atherosclerosis. These markers aid in diagnosing and predicting cardiovascular events in this high-risk population.

Area of Science:

  • Nephrology
  • Cardiology
  • Diabetology

Background:

  • Chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) are significant risk factors for cardiovascular disease.
  • Patients undergoing program hemodialysis often exhibit accelerated atherosclerosis.
  • The role of modified lipoproteins and immune complexes in this process requires further elucidation.

Purpose of the Study:

  • To determine the levels of desialylated apolipoprotein-B-100 (apoB-100) and lipoprotein-containing circulating immune complexes in hemodialysis patients with CKD and T2DM.
  • To assess the association of these markers with the extent of atherosclerosis and cardiovascular events.

Main Methods:

  • Study included 81 hemodialysis patients with CKD (36 with T2DM, 45 without).
  • Measured plasma levels of total cholesterol, triglycerides, desialylated apoB-100, and lipoprotein-containing immune complexes.
  • Assessed atherosclerosis using color duplex scan of brachiocephalic arteries to determine intima-medial thickness and stenosis.

Main Results:

  • Diabetic patients had higher total cholesterol and triglycerides (p<0.05).
  • Increased intima-medial thickness (13% higher) and prevalent plaques with stenosis (p<0.05) were observed in diabetic patients.
  • Significantly higher incidence of desialylated apoB-100 (46% increase) and lipoprotein-containing immune complexes (39% increase) in diabetic patients (p<0.05).
  • Diabetic patients with CKD experienced myocardial infarction 79% more often (p<0.05).

Conclusions:

  • Accelerated atherosclerosis in diabetic CKD patients on hemodialysis is linked to elevated modified low-density lipoprotein levels.
  • Desialylated apoB-100 and lipoprotein-containing immune complexes serve as potential diagnostic and prognostic markers for atherogenesis in this population.
Abstract

Keywords:
atherosclerosislipoprotein-containing circulating immune complexesmodified low density lipoproteinprogram hemodialysistype 2 diabetes mellitus

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